Functional foods/ingredients and periodontal diseases.

Periodontal diseases are a collection of inflammatory processes that affect the periodontium, that is, the teeth supporting tissues. Gingivitis (infected red swollen and easily bleeding gums) is a mild reversible form of periodontal disease. Almost 100% of the population suffers from time to time from gingivitis. Gingivitis can develop into periodontitis, which is a chronic inflammatory disease of the supporting tissues of the teeth [34]. In conjunction with red, swollen gums that easily bleed as a result of the disease, teeth may show exposed root surfaces and often dental radiographs reveal periodontal (alveolar) bone loss around the teeth due to the inflammation process; teeth will become mobile and migrate and will eventually exfoliate. Patients with periodontitis may have bad breath, suffer from important subjective and objective esthetic problems and experience problems with chewing due to tooth mobility and loss of teeth. Dental professionals provide labor-intensive treatment to periodontitis patients, including periodontal surgery. Like gingivitis, also periodontitis has a relative high prevalence in the population. About 10% of the total adult population and about 30% of individuals over the age of 50 years have been estimated to suffer from severe periodontitis [9]. Chronic, adult form of periodontitis progresses at a relative slow rate and is diagnosed during middle age. However, in some individuals, the disease manifests itself at adolescent or post-adolescent age in a rapidly progressive manner, and this form of disease is diagnosed as early onset periodontitis or aggressive periodontitis [42]. Periodontitis may be considered as a model for the other inflammatory diseases, with a pathogenesis that is multifactorial, involving complex interactions between multiple genetic traits, infectious agents and lifestyle factors such as diet and smoking. Several lines of data suggest that periodontitis may be associated with systemic diseases. For example, periodontitis has been associated with increased risk for cardiovascular diseases (for a recent review see [46]), possibly through the elevation of the acute-phase reactant C-reactive protein or other systemic markers of inflammation [24]. Oral bacteria may play an important role in the systemic reactions to periodontitis. There are strong indications that the inflamed and ulcerated subgingival pocket epithelium forms an easy port of entry for oral bacteria. Short moments of bacteremia occur most likely several times a day. Like any other inflammatory condition, untreated chronic periodontitis may pose a risk for the overall health of the subject [23]. The etiology of periodontitis is multifactorial, involving the following.